Women are the primary consumers of health care in general and of complementary and alternative medicine (CAM) in particular. In 1999, women in the United States spent more than $600 million for CAM therapies for menopause. Little is known about the prevalence of CAM use during menopause, characteristics of midlife women who choose CAM versus conventional therapies for menopause, and differences in types and prevalence of CAM use by racial/ethnic groups and with changes in menopausal status. Marketing and use of CAM for menopause management has increased dramatically in the past 10 years, yet very little is known about how women's choices about CAM may affect use of conventional health care during menopause. By the year 2025, the number of postmenopausal women in the United States will double that of the mid-1990s Changes in women's choices in selecting conventional hormone therapy and/or CAM use across the menopausal transition and the outcomes of these choices are topics that have taken on increased importance since the WHI announcements over the past year. Women may turn to CAM as a result, but these remedies are less well-studied and not necessarily free of adverse effects. The present application proposes to undertake analyses of data collected baseline through the annual 06 follow-up visit in the multi-ethnic cohort of 3300 midlife women included in the longitudinal Study of Women's Health Across the Nation (SWAN) and the CAM Supplement to the 2002 National Health Interview Survey (NHIS). The specific aims of the present application are: 1) To examine longitudinally racial/ethnic differences in and the demographic, lifestyle and medical factors that affect initiation and continuation of CAM use; 2) To determine the types of problems for which women use specific types of CAM in midlife and whether these differ by race/ethnicity and change longitudinally with changes in menopausal status; and 3) To compare the types of and reasons for CAM use in the SWAN cohort of midlife women, to those in women of similar age and racial/ethnic groups who were administered the 2002 NHIS supplemental CAM questionnaire. These aims will be achieved through secondary data analyses of existing data collected in the SWAN cohort from baseline through the sixth annual follow-up visit and comparison of the SWAN data to the 2002 NHIS CAM use data for the third aim. Our hypotheses emanate from preliminary examination of early data on CAM use in the cohort of midlife women in SWAN. The results of the present analyses will make a valuable contribution, not only to understanding the prevalence of CAM use in midlife women, but also the factors that affect use and the reasons for CAM use in this age group and how these reasons and determinants and types of CAM use vary by race/ethnicity and over the menopausal transition.